How to administer a tetanus shot: steps

Written by Ma Xian Shi
General Surgery
Updated on January 10, 2025
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First, an allergy test must be conducted. Based on the results of the allergy test, the application of tetanus antitoxin is decided. The allergy test involves drawing 0.1 ml of antitoxin serum, diluting it with 0.9 ml of isotonic saline, and then injecting 0.05 to 0.1 ml of the diluted solution intradermally on the flexor side of the forearm. An equivalent amount of isotonic saline is injected on the other forearm as a control. Observe for 15-30 minutes. If there is no nodule or resistance at the injection site, it is a negative result. Patients with a negative result can have the rest of the original liquid injected subcutaneously. If a red nodule of about one centimeter or resistance appears at the serum injection site, the allergy test is positive. In this case, a desensitization injection is needed. The desensitization injection involves diluting the required injection fluid and the antitoxin serum with isotonic saline to ten times the volume and administering it subcutaneously in divided doses. After dilution to ten times the volume, which is 10 ml, the initial dose of 1 ml is administered, followed by 2 ml, 3 ml, and 4 ml, with each injection spaced 30 minutes apart until completed.

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Written by Zhang Peng
General Surgery
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Can I breastfeed after getting a tetanus shot?

Current research indicates that lactating women are not contraindicated for tetanus vaccination; the main contraindication is allergy to the tetanus vaccine. Generally, if there are high-risk factors for tetanus infection, timely wound debridement and care should be performed, followed by early administration of passive immunization with tetanus vaccine. Generally, tetanus antitoxin can be used based on the results of a skin test. If the skin test result is strongly positive, its use should be avoided, and tetanus immunoglobulin should be chosen instead. The effective metabolic period of tetanus immunoglobulin is about three weeks. If high-risk factors for infection still exist beyond this time limit, timely enhancement of immune therapy should be considered. Regarding the tetanus vaccine, it is generally advised that the earlier it is administered, the better, as early administration can neutralize the tetanus toxin already present in the blood. However, if the tetanus toxin has already bound to nerve cells, treatment becomes relatively difficult.

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Written by Xu Jun Hui
General Surgery
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What is tetanus?

Tetanus infection occurs when Clostridium tetani invades the human body through skin and mucosal membranes, producing certain neurotoxins that lead to symptoms. As Clostridium tetani is an anaerobic bacterium, it typically thrives in anaerobic environments and is often found in heavily contaminated, muddy, or rusty conditions. Therefore, if there is an infection in a wound that is deep, located in an oxygen-poor environment, or heavily contaminated with dirt or rust, or in cases of extensive open fractures, explosion injuries, etc., anti-tetanus treatment is essential. It is generally recommended to administer an injection within 24 hours of the injury, which includes tetanus toxoid that requires a skin test—this is not to be used by patients with allergies—and tetanus immunoglobulin, which does not require a skin test.

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Written by Liu Huan Huan
General Surgery
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Criteria for a Positive Tetanus Diagnosis

After a person is injured, if the wound reaches deeper parts such as the subcutaneous fat layer or even the muscle layer, it is essential to administer tetanus antitoxin to prevent infection from tetanus bacillus. Before injecting the tetanus antitoxin, a skin test must be conducted to prevent allergies and anaphylactic shock. Generally, after injecting the test agent, observations are made for 30 minutes. If there is an enlargement of the wheal, redness and swelling that infiltrates surrounding areas, and the patient feels itching, it indicates a positive result.

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Written by Zhang Peng
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Symptoms of Tetanus

What are the symptoms of tetanus? Generally, the prodromal symptoms include overall weakness, headache, difficulty swallowing, or limited movement of the head and neck. If the condition progresses further, there may be typical symptoms such as difficulty opening the mouth or tense jaw muscles, leading to muscle spasms in the limbs, possibly causing spasms of the larynx, which can lead to breathing difficulties or even suffocation. Hence, it is a particularly severe manifestation. Some individuals may experience generalized tonic muscle spasms throughout the body, a milder manifestation with a typically longer incubation period. Therefore, in the treatment of tetanus, proactive active immunization should be pursued.

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Written by Li Xiao Lin
Emergency Department
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What are the symptoms of mild tetanus?

Symptoms of mild tetanus may include the following: Firstly, localized muscle spasms or brief spasms in a single muscle. Additionally, one may experience facial numbness, facial asymmetry, and difficulty swallowing. Generally, these symptoms are mild and do not affect normal life. Therefore, if tetanus occurs, one should first go to the hospital for further relevant examinations and treatment. The general treatment involves administering penicillin for infection control. Additionally, symptomatic treatment includes sedatives to reduce spasms. Attention should also be paid to diet; it is advisable to drink plenty of water and consume fresh vegetables and fruits. One should avoid spicy, stimulating foods, seafood, and yeast-containing foods like beef and mutton to minimize the occurrence of tetanus symptoms.